Headache and Migraine News » treatments

Magnesium for Migraine 2 – Combos?

James — Fri, 18 May 2012 01:19:40 +0000

Yesterday we talked about some of the things we’ve learned about magnesium supplements for migraine over the past few years. Today I just want to briefly talk about one more topic – supplements that contain magnesium and something else.

Again, this is something you’ll need to talk to your doctor about. But here are a few things that our visitors have said they are taking with magnesium. The ones mentioned most often come first:

Now that doesn’t include things like normal abortives and other medications. Remember, magnesium will not always eliminate migraine, so usually you’ll use it to cut down on attacks/symptoms, and then compliment it with other treatments.

Now, sometimes these are taken as separate supplements. But there are specially designed combinations of supplements that many have found useful for migraine.

Possibly the most popular is MigreLief, which is a combination of magnesium, riboflavin and feverfew. I would say it’s the magnesium supplement most often mentioned by our visitors, and it has a lot of research behind it.

Another is actually not a preventative, but an abortive. It’s called Migralex, and it contains magnesium and aspirin. People have reported that taking magnesium supplements during an attack helps – and in fact, magnesium has long been given intravenously for migraine.

Now you can check some of the links above for more on these additional supplements, but here’s some of the things our visitors have said. Note that I’m not always quoting their entire comment, just the relevant part.

Angela: I was researching on your website, and came across the articles about magnesium, feverfew, and riboflavin. I said to myself, why not try it?? Well, after only a week of taking the supplements, I was able to quit the daily headache powders, and now, after couple months, the headaches are non-existent most days, and just a dull ache that I can manage on one or two days a week!!

Laurie: I have found after suffering from migraines since a child that taking the magnesium and 200 mg of co-enzyme Q 10 in the morning with breakfast is the golden ticket. Would recommend taking a multi-vitamin and calcium with the evening meal.

okiegem: Then, about two years ago, I read something somewhere about magnesium and coenzymeQ10, and tried them. After a few weeks, I realized my migraines were GONE! I take 400mg CoQ10 and 500mg magnesium oxide, which I get at the local Wal-Mart, and I really am migraine-free! It has truly been life-altering.

Angie: A friend from work told me that her Dr had told her about a Magnesium/Riboflavin (B2) combo that seemed to be helping her, I felt like I had nothing to lose by giving it a try. IT WORKED! The Mag Oxide was not overly helpful, but the Mag Citrate made all the difference in the world.

Liz: I tried everything under the sun as well as multiple doctors and was at the end of my rope. I too decided to take things into my own hands and weaned myself off topamax and zonisimide, then later depakote. I now am ONLY taking supplements. Magnesium, feverfew and CoQ10.

Dawn: Magnesium, feverfew, butterbur, Vit. B and CoQ10 are what I’m using to control the migraines – doing much better and NO side effects!!

Does magnesium work for everyone? Of course not. Obviously I’m quoting from people who have found some success. That way you can see what actually works in real life.

A note on Cluster Headaches

Before closing, one note about cluster headaches. People with cluster have also responded to magnesium supplements, and intravenous magnesium. Here’s an article about magnesium and Botox. And here is what one website visitor had to say:

Terri: I was very suspicious, after leaving the hospital, as to what affects the antibiotic was going to have on my body. After leaning on YOUR SITE that, indeed, an antibiotic can deplete your system of magnesium (3 days ago), I started taking Magnesium 500 and B2 200 and noticed an immediate improvement. We had some bad (rain) weather yesterday which increases my clusters so I can’t tell yet how much improvement I will ultimately have, but I’m thinking this may be the answer for me.

Thanks again for your emails and comments – they are a huge help to others! Keep up the great commenting!

Speaking of commenting, if you have had success with a combo supplement with magnesium, now is your chance to leave a comment!

From the Headache and Migraine News Blog

Magnesium for Migraine 2 – Combos?

These other posts might relate:

Which Magnesium Supplements Work?

James — Thu, 17 May 2012 01:10:42 +0000

We’ve had a lot of discussion here about magnesium for migraine. One of the most popular versions of magnesium for migraine is magnesium citrate. But some ask, what if magnesium citrate isn’t working? Or is there a better magnesium citrate supplement for headache? What about the dosage of magnesium for migraine?

Instead of bringing a lot of new information today, I went over some of the practical suggestions that we’ve discussed here before.

Which Magnesium should I take for migraine?

Here are some of the key suggestions:

Do NOT take a magnesium supplement that contains calcium. Read the label. If you take calcium supplements, take them at another time of day.
Usually, the "ate" forms, such as citrate or glycinate are better absorbed. Although some have recommended magnesium oxide, most people are still going for the "ate" forms.
If magnesium tablets aren’t working well for you, try capsules or liquid/water soluble magnesium.
If you’re getting diarrhea, your magnesium probably isn’t absorbing well. Try another type.

Now, what specific brands or types of magnesium have been recommended here? Here are the most common:

Ultra-Mag Magnesium Complex (also available at Vitacost) (tablets of 400mg, magnesium citrate, taurinate, malate, glycinate, and succinate)
Solaray BioCitrate Magnesium (capsules of 133.3mg, magnesium citrate)
Calm Organic Orange (liquid/water soluble, magnesium citrate)
Trace Minerals Research Mega-Mag (liquid/water soluble, their own blend of magnesium from the Great Salt Lake)
Flora Floradix Magnesium Liquid Mineral Supplement (liquid/water soluble, magnesium gluconate and magnesium citrate)
Solaray Magnesium Glycinate (capsules, magnesium glycinate, 100mg)
Solaray Magnesium Asporotate (capsules, magnesium asporotate, 200mg)

I notice that it can be confusing how much you get in a bottle. Watch for how many capsules, for example, you need to get a serving.

Here are a few specific comments from you our visitors:

Liz says: I had only been told by my neurologist to take Magnesium during menstruation. Also i take a more rare, and highly unavailable kind-magnesium glycinate. It didn’t seem to make much of a difference, but after doing more research I’ve up’d my dose to 400mg/day and will likely double that will menstruating. It has already begun to make a difference!

Judith: Recently (summer 2010) you published a testimonial by a reader who indicated that she had had impressive results by using Solaray brand Magnesium Asporotate. I switched to Magnesium Asporotate in August 2010. In September the frequency of my migraines began to drop off. … I credit the magnesium asporotate with my 8 week freedom from migraines. This is huge!

Angie: I am still on Magnesium, James. I still have severe attacks but also mild ones and less vomitting. I am able to walk my dog even while having an attack…I also found this Mg citrate in liquid form [Flora Floradix Magnesium Liquid Mineral Supplement]. It is what I am taking now.

Aurora: It didn’t stop me from having my attacks, but I am a bit "useful" now than before and the nauseous feeling is lesser so I vomit lesser, too. I found this Magnesium in syrup form—Floradix Magnesium! Tastes like tropical fruits with honey so I don’t have to take those large chewable tables.

Evie: I’ve been taking the Solaray brand of magnesium citrate from Whole Foods because it comes in a capsule which is more easily absorbed than a tablet. … I really noticed a difference and though I’d still get migraines, they were less often and much, much more bearable.

Now, there are some combinations, magnesium + something else, but we’ll talk about those tomorrow. Let’s talk about dosages next.

How much magnesium supplement should I take?

With the disclaimer that you should always talk to your doctor about the dosage that’s right for you, here are some suggestions and comments from our visitors.

First, let me tell you what my research has turned up. Generally, around 400mg per day seems to be a good place to start for migraine. But many are now suggesting larger doses, like 800mg-1200mg. So you’re probably looking at 400-1200mg of magnesium daily, usually in more than one dose (ie 400mg 3x per day). Your doctor will probably recommend starting with a lower dosage and raising it slowly.

Now let’s see some of the experiences of our visitors.

Stephen says: My neurologist told me that the key to dosing magnesium is to increase until it causes diarrhea and then back off until it doesn’t. I am up to 1250 mg and climbing but it is magnesium oxide so I don’t really know how much I am absorbing.

Shari writes: 700 mg of Magnesium was recommended to me by my neurologist.

Rachael: [My doctor] recommended I take 500 mg of magnesium every day. I started this two weeks ago and I have had two minor headaches that I didn’t have to take any medication for and I have not had a migraine since starting the magnesium.

Also we have Liz’ comment above, saying that she wanted to try 400mg and double that during menstruation. We do know that magnesium levels change in women depending on your time of the month. See more about Menstrual Migraine here.

So if you haven’t taken magnesium, give it a try! If your magnesium citrate isn’t working, try a different type of magnesium, or a liquid supplement.

There should be a lot of ideas here to get started. But there’s more – a lot of people are trying combinations, and that’s what we’ll talk about tomorrow.

Meanwhile, what are your suggestions? Is there some form of magnesium you’ve found especially helpful?

From the Headache and Migraine News Blog

Which Magnesium Supplements Work?

These other posts might relate:

From Current Studies: What Migraine Treatments Work?

James — Wed, 02 May 2012 00:03:06 +0000

New guidelines have just come out based on the evidence we currently have for migraine treatment. We’ll talk about some of the guidelines in a moment, but first there are some key things to remember.

Caution: Dangerous Waters Ahead!

These guidelines were created by checking out the studies that have been published to date. This means that we do or do not have high quality studies that show successful treatment using [whatever medication or supplement]. If we don’t have enough quality studies, the item will be lower on the list.

We should also note that the guidelines are talking about what works in general, NOT what works for you or what is best for you. Some treatments high on the list are also high in side effects. Or they may be dangerous for certain people. Or they may not work well for your particular type of migraine. Do not take this as a list of what to try first. Something lower on the list may be something far better for you that something on the top.

This list also doesn’t address combo-treatments, such as MigreLief (with magnesium, feverfew and riboflavin).

The list does help doctors prioritize what to consider. If you’ve tried a number of things and haven’t tried something high on the list, it may be time to ask your doctor about it.

Highest rated treatments

Here are some of the highest rated treatments for migraine. There are four categories:

Over-the-counter: Petasites (butterbur) (such as Petadolex)
Triptans: frovatriptan (especially recommended for menstrual migraine)
Antiepileptics: divalproex sodium, sodium valproate, topiramate
beta-blockers: metoprolol, propranolol, timolol

Lowest rated treatments

These are the items that had a negative rating, meaning that they’re not recommended at this time: Lamotrigine, Clomipramine, Acebutolol, Clonazepam, Nabumetone, Oxcarbazepine, Telmisartan, montelukast.

Everything in-between

Of course, just because something isn’t on the top of the list doesn’t mean it’s not an excellent, helpful treatment for many people. For example, very close to the top were well-recognized treatments such as amitriptyline, zolmitriptan, feverfew, naproxen sodium, riboflavin (vitamin B2), and magnesium.

It should also be noted that Botox migraine treatment was not a part of these studies.

For some of the medications that are being used today, check out Migraine Medications: So many choices.

From the Headache and Migraine News Blog

From Current Studies: What Migraine Treatments Work?

These other posts might relate:

Botox and Magnesium for Cluster Headache?

James — Wed, 11 Apr 2012 01:33:06 +0000

Yesterday Dr. Alexander Mauskop reported on a man who has been taking Botox and magnesium for cluster headaches for three years. He’s found it very helpful, although the treatment is not alone. Here’s what he’s taking:

verapamil
intravenous magnesium (every 3 weeks to one month)
Botox injections (every 2-4 months, usually between 2-3)
To take for an attack, he usually uses rizatriptan (Maxalt) tablets or zolmitriptan (Zomig) nasal spray. If he needs more he takes sumatriptan (Imitrex) injections

Dr. Mauskop says he has found that about 40% of cluster patients are magnesium deficient, and respond to the magnesium injections. The Botox also seems to be helpful, but there are few long term cases. The interesting thing about this case is that the man has taken Botox over the course of 3 years.

All of these medications are also used for migraine, though verapamil is one of the less common ones.

For more, read Dr. Mauskop’s post: Botox for chronic cluster headaches

From the Headache and Migraine News Blog

Botox and Magnesium for Cluster Headache?

These other posts might relate:

Watch for it – Ketamine for Migraine and More

James — Fri, 30 Mar 2012 15:26:53 +0000

Using ketamine for pain is not a new idea. But I think we’re going to see it get an increasing amount of attention in the months ahead.

A few weeks ago, NPR featured a news story on the use of ketamine for depression. Ketamine, originally developed as a human anaesthetic, has since been used for various applications in medicine.

It’s also used as an illegal drug, gaining fame as "K", "Vitamin K" or "Special K".

In recent years there has been sporadic interest in using ketamine for pain. It’s a difficult drug to study, because it tends to be rather obvious that you’ve taken it.

But it has been suggested as a treatment for cluster headache, familial hemiplegic migraine, chronic daily headache, and migraine, as well as other types of pain.

Ketamine is a neurological drug, classed as a NMDA (N-methyl-D-aspartate) receptor antagonist. It is believed to work in a number of different ways in the brain – relating to calcium channels, serotonin, and glutamate – terms that will be familiar with migraine researchers in particular. In fact, ketamine has been especially useful in the treatment of headache or migraine that just won’t go away and isn’t responding to other kinds of treatment (refractory). It’s given as an IV or intranasal treatment. Of course, this means it’s way down on the list of treatments that will be given – it’s rare and even when it’s tried it’s often not successful.

However, with the growing interest in ketamine for depression, the game changes. You can bet that there will be increased interest in ketamine for chronic pain conditions, which often come hand in hand with depression.

Although increased interest doesn’t mean this should be the drug of choice for most people, it does mean that more research will be done. It may be a treatment that will help a few patients whose pain is seemingly unstoppable.

For more on the background of ketamine, read Ketamine and MDARs in the treatment of neuropathic pain from Dr. Jan M. Keppel Hesselink. For a review of the studies on ketamine for other types of pain aside from headache, read Ketamine in Chronic Pain Management: An Evidence-Based Review

From the Headache and Migraine News Blog

Watch for it – Ketamine for Migraine and More

These other posts might relate:

Spinal Cord Stimulation (video)

James — Thu, 22 Mar 2012 02:32:45 +0000

It’s being used for migraine and other types of chronic pain when other treatments haven’t worked. Here’s an interview with one patient about his experiences with the treatment. In his case, the pain was back pain.

Have you tried spinal cord stimulation for migraine? What was your experience?

From the Headache and Migraine News Blog

Spinal Cord Stimulation (video)

These other posts might relate:

Spinal Cord Stimulation trial announced

Sinus Headache: Say NO to Antibiotics!

James — Thu, 01 Mar 2012 21:58:11 +0000

There is increasing evidence that those who a diagnosis of sinus headache, or a self-diagnosis of sinus headache, should NOT be taking antibiotics. Why?

First of all, a number of studies have suggested that many – perhaps most – perhaps even 80%-90% – of these patients actually have migraine.

So chances are you should be taking migraine meds instead of sinus meds.

A study published in Neurology in 2002 (Lipton et al) looked at patients with migraine who also supposedly had sinus headaches. Patients were given analgesics, antihistamines, and/or decongestants for their headaches. About half were dissatisfied with these treatments.

These patients then took migraine medication for two of their "sinus headaches" – in this case, sumatriptan. Surprise surprise, 73% had pain relief within 2 hours. 45% were pain free within two hours!

Antihistamines, decongestants, antibiotics – all big business. But what if most were being given to the wrong people?

The misdiagnosis likely has to do with the high prevalence of congestion and other sinus headache symptoms in migraine. Many people don’t realize that congestion is common in a migraine attack, or even nasal discharge. And many doctors are confused as well.

But what if you’ve had a proper work-up, and you believe you do have a sinus infection? (More on how to differentiate between a migraine attack and sinus headache here) Chances are you should still say NO to antibiotics.

Most often, sinus headaches from an infection are due to a virus infection – and a virus infection will not be helped by antibiotics.

A recent study in the Journal of the American Medical Association confirms this in real life. 85 adults with uncomplicated acute sinusitis were given an antibiotic, and 81 were given a placebo. (see Author Insights: Treatment of Acute Sinusitis With Antibiotics Often Futile)

At 3 days, there was no difference between the groups in quality of life or symptom relief. At 10 days, there was no difference between the groups in quality of life or symptom relief. No difference!

In the USA, 1 in 5 antibiotic treatments is given to someone with sinusitis. That’s a HUGE number of people in one country alone getting a medication they don’t need, that won’t help them!

And those were patients who most likely really had sinusitis.

So let’s take the millions who are diagnosed with, or believe they have, sinus headache. Subtract most of them – they actually are having a migraine attack.

Now take the few that remain – should we give them antibiotics? Most likely not.

That’s millions of people with so-called sinus headache – almost all of whom should should NOT be taking antibiotics (or antihistamines, or decongestants…). And that probably means you, sinus headache sufferer.

In a world where we’re more and more concerned about the personal and worldwide impact of overuse of antibiotics, it’s time we cut those millions of prescriptions. If you’re not sure, do some research and be sure that you not only have a sinus infection, but an actual bacterial infection (not viral), AND that it’s worth it to take the antibiotics.

Unless you’re in that tiny minority, do yourself and us a favour – get a proper diagnosis, and if you need to take something that will actually help you.

From the Headache and Migraine News Blog

Sinus Headache: Say NO to Antibiotics!

These other posts might relate:

Methods that are Really Fighting Neck Pain

James — Fri, 24 Feb 2012 17:46:11 +0000

Killing migraine-triggering neck pain – what’s the best way? A recent study looked at a related question.

Last week we were talking about the pain that comes along with migraine – of which neck pain is at the top of the list.. We also were talking about how other issues – painful issues, such as neck pain, can lead to migraine. A new study published this month in the Annals of Internal Medicine (an academic journal published by the American College of Physicians) looked at three ways that people dealt with neck pain – and what worked the best.

The study looked at three groups of patients – those taking medication, those using exercise (therapeutic exercise done at home), and those taking chiropractic treatment.

After twelve weeks, here are the results. The chart below shows the % of patients who experienced at least 75% relief:

The clear winner was chiropractic, with 57%. Of those taking medication, only 33% found that much relief.

But there’s more. A year later, 53% of those who received chiropractic treatment still had 75% relief, and only 38% of those on medication.

My chiropractor always urged me to do exercise at home on top of regular adjustments. This study seems to suggest he was right. It would be interesting to see how people fared who used a combination of treatments.

From the Headache and Migraine News Blog

Methods that are Really Fighting Neck Pain

These other posts might relate:

MigreLief: An Interview with Curt Hendrix (video)

James — Thu, 23 Feb 2012 17:05:33 +0000

What follows is an interview on Lifetime Television "The Balancing Act" with Curt Hendrix, founder of the company that makes MigreLief, a well known natural supplement for migraineurs. MigreLief started out as a single product (MigreLief Original), but there is now also MigreLief+M (Menstrual Formula) and Children’s MigreLief. Many people have found relief with these supplements.

From the Headache and Migraine News Blog

MigreLief: An Interview with Curt Hendrix (video)

These other posts might relate:

Questions about Botox in the UK

James — Thu, 16 Feb 2012 18:27:22 +0000

In July 2010, Botox was approved as a preventive treatment for chronic migraine in the UK by the Medicines and Healthcare Products Regulatory Agency. But is there enough evidence for Botox? Should it be offered (funded) by the NHS (National Health Service) across England and Wales?

Medicine watchdog NICE (The National Institute for Health and Clinical Excellence) is saying "not yet". They feel that more data is needed, and they’re asking the makers of Botox (Allergan) to provide it.

Although the people with NICE admit that Botox seems to have some benefits in recent studies, they claim that the benefits have been small – small enough that they could be explained simply by the way the studies were conducted.

Proffesor Carole Longson, director of the health technology evaluation centre at NICE said,"Without this additional evidence, potentially we will be unable to advise the NHS that this drug is good value for money for these adults because there are currently too many uncertainties."

But NICE remains open to comments on their recommendation before they make it official. The deadline will be the 8th of March, after which NICE will put together it’s final guidelines.

The Migraine Trust and The British Association for the Study of Headache prepared a joint statement in response to NICE. As a part of their statement they said:

We know that BOTOX® is effective for some but not all patients who suffer from chronic migraine. We also know that many other preventative treatments are not effective for treating chronic migraine and that they can cause unacceptable side-effects. It would be extremely unfortunate if this treatment is denied to those who have exhausted all other options and those who have responded well to the treatment. The Migraine Trust advocates that this treatment should be made available to those who fail to respond to at least three preventative treatments to have a fair chance to see if BOTOX® treatment will work for them.

Read the full statement here.

From the Headache and Migraine News Blog

Questions about Botox in the UK